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The impact of an exercise and sport intervention on cognitive function and pain among forcibly displaced individuals at risk for PTSD: a secondary analysis of the SALEEM randomized controlled trial
Knappe F, Filippou K, Hatzigeorgiadis A, Morres ID, Ludyga S, Seelig H, Tzormpatzakis E, Havas E, Theodorakis Y, von Kanel R, Puhse U, Gerber M
BMC Medicine 2024 Sep 12;22(387):Epub
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: In response to the global scope of forced displacement, international organizations highlight the need of scalable solutions to support individuals' health and integration into host societies. Exposure to high mental and physical stress perceived before, during, and after displacement can impair functional capabilities, essential for adapting to a new environment. This secondary analysis examined the impact of an exercise and sport intervention on cognitive function and pain severity among individuals living in a refugee camp in Greece. METHODS: We implemented a randomized controlled trial involving n = 142 (52.8% women) forcibly displaced individuals from Southwest Asia and Sub-Saharan Africa. Participants were randomly assigned to a waitlist or a 10-week co-designed exercise and sport intervention with a 1:1 allocation rate between groups and sexes. Assessments at baseline and follow-up included the Flanker task, the Oddball paradigm, pain severity via visual analog scales, and the Astrand-Rhyming indirect test of maximal oxygen uptake. We analyzed the intervention effects using structural equation modeling. RESULTS: Our findings did not indicate a direct intervention effect on cognitive function or pain (p >= 0.332). However, the intervention group significantly improved cardiorespiratory fitness, s = 0.17, p = 0.010, which was associated with faster reaction times in cognitive tasks, s = -0.22, p = 0.004. Moreover, there was some evidence that adherence might be linked to reduced pain severity, s = -0.14, p = 0.065. CONCLUSIONS: Exercise and sport did not directly impact cognitive function and pain severity among a sociodemographically diverse sample living in a refugee camp, suggesting the need for complementary measures. Nevertheless, our results indicate that improvements in cardiorespiratory fitness benefit aspects of attention. TRIAL REGISTRATION: The study was approved by the local ethics committee of the University of Thessaly (no. 39) and registered prospectively on February 8, 2021 at the ISRCTN registry (no. 16291983).

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